Health inspection·June 17, 2024

F 0677 Provide care and assistance to perform activities of daily living for any resident who is unable. Level of Harm - Minimal harm or potential for actual harm Based on medical record review, observation, and interview the facility failed to provide oral care in a timely manner. This affected one (Resident #1) of three residents reviewed for activities of daily living. The census was 139. Residents Affected - Few Findings include: Review of the medical record for Resident #1 revealed an admission date of 11/13/20. Diagnoses included schizoaffective disorder, type two diabetes, morbid obesity, unspecified dementia. Resident #1 required assistance with personal care. Review of the quarterly Minimum Data Set (MDS) assessment, dated 04/26/24, revealed Resident #1 had intact cognition and was dependent for bed mobility, transfers, and oral care. Review of the Plan of care dated 01/19/20 revealed Resident #1 had impaired dentition and was at risk for oral problems related to broken, loose teeth with interventions including to provide oral care at least daily and/or more frequently as needed. Review of the oral care task sheet for Resident #1 dated 05/20/24 through 06/17/24 revealed on 05/22/24, 05/24/24, 05/25/24, 05/26/24, 05/27/24, 05/30/24, 06/03/24, 06/03/24, 06/06/24, 06/08/24, and 06/13/24 there was no documentation oral care was completed. Interview on 06/17/24 at 8:41 A.M. with Resident #1 revealed he did not receive oral care daily and he had not received oral care this morning. Observation of Resident #1 revealed his teeth were not clean and he was not shaved. Interview on 06/17/24 at 8:59 A.M. with State tested Nurse Assistant (STNA) #204 revealed he did not complete Resident #1's oral care because third shift staff were responsible for providing oral care. Record review and interview on 06/17/24 at 11:13 A.M. with Assistant Director of Nursing (ADON) #208 and ADON #210 verified oral care was not documented as completed for Resident #1 on 05/22/24, 05/24/24, 05/25/24, 05/26/24, 05/27/24, 05/30/24, 06/03/24, 06/03/24, 06/06/24, 06/08/24, and 06/13/24. There was documentation that oral care was provided on 06/17/24 at 9:32 A.M. A follow up interview on 06/17/24 at 11:18 A.M. with STNA #204 verified that he had not completed oral care for Resident #1 on 06/17/24. Observation of Resident #1's oral cavity on 06/17/24 at 11:23 A.M. with ADON #208 and ADON #210 Page 1 of 2 365134 365134 06/17/2024 Hickory Ridge Nursing & Rehabilitation Center 721 Hickory St Akron, OH 44303

F 0677 Level of Harm - Minimal harm or potential for actual harm verified Resident #1 had caked on food debris between his teeth. Both ADON #208 and #210 indicated oral care had not been completed. This deficiency represents non-compliance investigated under Complaint Number OH00154437. Residents Affected - Few 365134 Page 2 of 2